The HIV Vaccine Renaissance - Reflections on World AIDS Vaccine Day

Today, 18th May is World AIDS Vaccine Day, marks the day, 13 years ago, when U.S. President Bill Clinton challenged the world to develop an AIDS vaccine within a decade.

We now know that this time frame was overly optimistic, but in 1997, most of us could not have conceived how difficult the task would prove to be. Still, World AIDS Vaccine Day on 18 May will live on until we have found an AIDS vaccine. On this day we want to inform people that AIDS is still a major health crisis and that we need to do much more to prevent people becoming infected. Every day, there are 7400 people who become infected with HIV. Most of them live in Sub-Saharan Africa, and many are young people in the prime of their lives. AIDS is an important barrier to pulling developing countries out of their poverty. We therefore must end AIDS.

To achieve that, we need a comprehensive response to fight this pandemic. What this means is continued commitment to expanding access to ARVs and current methods of prevention. And it means ongoing research to develop additional intervention options, including preventive vaccines and microbicides. Learning more about the drivers of the AIDS epidemic and successful prevention methods will be critical to help to reduce the number of new HIV infections and to develop new culturally-relevant preventive tools.

In the 27 years since HIV was discovered, scientists have learned a great deal about the virus and how it causes AIDS. Making a vaccine to prevent or control infection, however, has proved a greater challenge than anyone could have imagined, and the field has seen its fair share of setbacks. It is therefore particularly encouraging that on this World AIDS Vaccine Day we can reflect on important progress in research.

In late September 2009, a large-scale study (known as RV144 or the Thai trial) testing a combination of two vaccines in Thailand showed that it was able to prevent HIV infection in one out of every three people. That is not enough to bring this vaccine to market, but it was the first time that an HIV vaccine candidate had showed a benefit in people. The next step is for researchers to develop a vaccine that is considerably more effective.

A few weeks prior to that, researchers at and affiliated with the International AIDS Vaccine Initiative (IAVI) announced the discovery of two new antibodies capable of neutralizing a broad range of HIV variants. These were the first potent and broadly neutralizing antibodies to be identified in more than a decade and the first to come from a donor in the developing world. Also, these antibodies recognize a site on the outside of HIV that is a useful target for vaccine design. These efforts are valuable to researchers working to design a vaccine that would produce such powerful antibodies in people in order to help to block HIV from establishing an infection.

The AIDS vaccine field did see significant scientific progress over the past year, essentially experiencing a renaissance. But we have a long road ahead. There is a lot more important research to do in the coming years. Success in that endeavor will depend on the continued support of researchers, donors, policymakers, and advocates.

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